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Objective To identify the disease burden and indirect economic burden caused by lung cancer in Kunshan City, Jiangsu Province, from 1981 to 2020. Methods The incidence and death cases of lung cancer were obtained from cancer registry and death cause monitoring data. The disability adjusted life years (DALY) was used as the evaluation index for burden posed by lung cancer on health, and the indirect economic burden was calculated by a human capital method. Results From 1981 to 2020, a total of 9272 deaths due to lung cancer were reported in Kunshan, of which 7106 were males and 2166 were females. The DALY caused by lung cancer in the whole population were 3.81, 4.14, 4.38, and 9.46 in 1981–1990, 1991–2000, 2001–2010, and 2011–2020, respectively. The indirect economic burden caused by lung cancer was 10.515, 141.657, 813.794, and 6659.149 million yuan. From 2011 to 2020, the ratios of years of life lost due to premature mortality to DALY in males, females, and the general population were 92.42%, 95.15%, and 93.60%, respectively. Conclusion The health burden and indirect economic burden for lung cancer are substantial in the Kunshan City. Moreover, age-specific DALY and indirect economic burden are not exactly symmetrical, suggesting that an effective control strategy to lower cost is urgently needed, especially for individuals aged 40-59.
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@#Objective To analyze the clinical features of patients with hepatolenticular degeneration (HLD) complicated by hepatic myelopathy (HM). Methods A retrospective analysis was performed on the clinical features,auxiliary examinations,diagnosis and treatment,and outcomes of 5 patients diagnosed with HLD complicated by HM in our hospital from January 2018 to February 2023,and the relevant literature was reviewed. Results Among the 5 patients,4 were male and 1 was female; the age of onset of HM ranged from 16 to 32 years. All 5 patients had manifestations of decompensated cirrhosis,and 3 patients had a history of transjugular intrahepatic portosystemic shunt (TIPS). The spinal MRI showed abnormal signals in the thoracic cord in 2 patients. Electromyography showed abnormalities in 3 patients,and electroencephalography showed significantly slower background brain waves in 4 patients. Two patients underwent liver transplantation,and 2 patients received endovascular treatment. One patient died of upper gastrointestinal bleeding; the other 4 patients had varying degrees of recovery. Conclusion The prevalence of HLD complicated by HM is very low. High copper status,hyperammonemia,TIPS,anemia,hypoproteinemia,and portal hypertension are directly associated with HM.
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@#Objective To analyze the characteristics of changes in hippocampal head,body,and tail subregions of patients with hepatolenticular degeneration (HLD) and their relationship with anxiety and depression. Methods Fortyfive patients with HLD and 30 healthy controls were recruited. T1-weighted magnetic resonance images were acquired. The hippocampus was manually segmented using FreeSurfer 7.2 for volume comparison between the groups. Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale (HAMD) scores were collected. The relationship between the volumes of hippocampal subregions and HAMA and HAMD scores was analyzed. Results The volumes of the head,body,and tail subregions of both hippocampi of the patients with HLD were all decreased significantly (P<0.05). In the patients with HLD,the volumes of the hippocampal head (P=0.020),the hippocampal tail (P<0.001),and the whole hippocampus(P=0.001) on the right side were significantly larger than those on the left side,with no significant difference for the hippocampal body (P=0.322). The HAMA score was negatively correlated with the left hippocampal head volume (r=-0.256,P=0.047). The HAMD score was negatively correlated with the volumes of the left hippocampal head (r=-0.267,P=0.037),the left hippocampal tail (r=-0.017,P=0.037),the right hippocampal head (r=0.331,P=0.009),and the right hippocampal body (r=-0.265,P=0.039). Conclusion The volume of hippocampal subregions was decreased in HLD,which was more marked on the left side. The volume of hippocampal subregions was closely correlated with anxiety and depression in patients with HLD.
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Objective:To explore the interaction between hyperuricemia and gender on dyslipidemia in the elderly.Methods:A cross-sectional study. The permanent residents aged≥65 years in Kunshan City were selected by the cluster sampling method. The selected residents underwent physical examination and blood biochemical tests such as blood glucose, blood lipid, uric acid, hyaluronic acid, gamma glutamyltransferase and creatinine, and history of schistosomiasis infection was investigated. Multivariate logistic regression analysis was used to analyze the relationship between various factors and dyslipidemia. Synergy index (S), relative excess risk of interaction (RERI) and the attributable proportion due to interaction (AP) were used to evaluate the association between hyperuricemia and female interaction on dyslipidemia.. The dose-response relationship between serum uric acid level and dyslipidemia was analyzed by a restricted cubic spline regression model.Results:The prevalence of dyslipidemia in the elderly aged 65 years and obove was 31.9% (1 450/4 536), and it was 23.7% (517/2 180) and 39.6% (933/2 356) in men and women, respectively ( χ2=131.38, P<0.001). Multivariate regression showed that female, high waist circumference, overweight and obesity, hypertension, diabetes, low glomerular filtration rate, high gamma-glutamyltranspeptidase, high uric acid to creatinine ratio, low neutral to lymphocyte ratio were associated with dyslipidemia (all P<0.05). Additionally, additive interaction association was found between the dyslipidemia and advanced uric acid levels ( OR=1.09, 95% CI: 1.07-1.12) and female ( OR=1.12, 95% CI: 1.11-1.14), and the contribution rate of interaction effects was 19.8% (RERI=0.74, 95% CI: 0.06-1.42; AP=0.20, 95% CI: 0.04-0.36, S=1.37, 95% CI: 1.02-1.84). Non-linear dose response relationship was identified by the restricted cubic spline regression model between the continuously rising serum uric acid and dyslipidemia ( χ2=101.23, P<0.001). Conclusions:The proportion of dyslipidemia in elderly permanent residents is high. Demographics and physical measurement indicators comprehensively affected the prevalence of dyslipidemia. In addition, both hyperuric acid and female have additive interaction on dyslipidemia.
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Objective:To explore the joint association of education attainment and sedentary with insufficient physical activity in Kunshan, Jiangsu province.Methods:Multi-stage cluster random sampling method was conducted in 2016 in Kunshan City, physical activity levels were collected according to structure questionnaire, and multivariate logistic regression was used to identify factors associated with physical activity level. Logistic model was used to estimate interaction effect by the synergy index (S), the relative excess risk of interaction (RERI) and the attributable proportion due to interaction (AP).Results:Housework, traffic and regular exercise physical activity accounted for 10.23%, 41.84%, and 28.98%, respectively. Insufficient physical activity in total, male, and female population were 50.66% (95% CI: 49.04%-52.28%), 52.29% (95% CI: 49.94%-54.64%), and 49.29% (95% CI: 47.06%-51.52%). Multivariable logistic regression analysis demonstrated that high waist to hip ratio ( OR=1.12, 95% CI: 1.02-1.23), free of family history of hypertension ( OR=1.24, 95% CI: 1.14-1.36), newly diagnosed diabetes ( OR=1.35, 95% CI: 1.09-1.68), previously diagnosed diabetes ( OR=1.34, 95% CI: 1.07-1.69), awareness of waist ( OR=1.34, 95% CI: 1.21-1.48), and lower level of high density lipoprotein ( OR=1.14, 95% CI: 1.03-1.27) were positively correlated with insufficient physical activity. Moreover, high educational attainment ( OR=1.27, 95% CI: 1.10-1.46) and sedentary duration ( OR=1.37, 95% CI: 1.20-1.57) were associated with insufficient physical activity, and additive interaction was found between two factors on insufficient physical activity (RERI=0.367, 95% CI: 0.105-0.629. AP=0.183, 95% CI: 0.060-0.306. S=1.572, 95% CI: 1.079-2.289). Conclusion:Among permanent residents whose age between 18-69 years in Kunshan, insufficient physical activity is more prevalent, high education and sedentary are jointly associated with insufficient physical activity.
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Multi-stage cluster random sampling method was conducted in 2016 in Kunshan City, Jiangsu Province. 8 529 permanent residents aged 18-69 years with completed questionnaire and physical examinations were obtained. After being weighted according to complex sampling scheme and post-stratification, the sample was used to estimate the prevalence and awareness of dyslipidemia. The associated influence factors for prevalence and awareness of dyslipidemia were evaluated through multivariate logistic regression. The results revealed that the prevalence and awareness of dyslipidemia were 35.2%(95%CI 33.7%-36.8%)and 13.0%(95%CI 11.3%-14.8%), respectively. After adjusting confounding factors, multivariate logistic regression analysis demonstrated that body mass index(BMI)≥28 kg/m2(OR=2.26, 95%CI 1.93-2.66), higher waist to hip ratio(OR=1.77, 95%CI 1.60-1.95), family history of diabetes(OR=1.19, 95%CI 1.03-1.36), hypertension(OR=1.26, 95%CI 1.11-1.44), diabetes(OR=1.83, 95%CI 1.55-2.16)were independently associated with dyslipidemia. BMI≥28 kg/m2(OR=1.71, 95%CI 1.30-2.25), higher waist to hip ratio(OR=1.65, 95%CI 1.29-2.10), hypertension(OR=1.87, 95%CI 1.47-2.38), diabetes(OR=1.64, 95%CI 1.24-2.16) were independently associated with awareness of dyslipidemia. (Chin J Endocrinol Metab, 2018, 34: 573-577)
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Objective To examine the temporal trend of mortality and probability of premature death from chronic respiratory disease in Kunshan City, Jiangsu Province. Methods Records of chronic respiratory disease death were derived from the vital registry system. Crude death rates, age-standardized mortality rate, and probability of premature death were calculated. Annual percent changes (APC) were estimated to examine the temporal trend. Results The crude death rate of chronic respiratory disease decreased from 129.14/105in 1993 to 41.10/105in 2016, and its APC was-4.1% (95% CI:-5.1%--3.1%, P<0.01). Age-standardized mortality rate decreased from 107.85/105in 1993 to 14.60/105in 2016 for both sexes (APC=-7.7%, 95% CI:-8.6%--6.8%, P<0.01). Moreover, the probability of premature death from chronic respiratory disease decreased from 3.96% in 1993 to 0.28% in 2016 (APC=-13.2%, 95% CI:-14.7%- -11.7%, P<0.01). Conclusion The mortality rate of chronic respiratory disease decreased substantially from the year 1993 to 2016 in Kunshan City. Residents are less likely to die of chronic respiratory disease before 70 years of age.
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Objective This study aimed to examine temporal trends in all cancer-eliminated life expectancy and potential years of life lost (PYLL) in Kunshan city, Jiangsu province, between 1981 and 2015. Methods Data were collected from the vital records of Kunshan city. Cancer-eliminated life expectancy and PYLL were calculated by sex,and the Chinese population from the year 2000 was used to calculate age-standardized PYLL. Estimated annual percentage changes (APC) and 95% confidence intervals (CI) were used to examine temporal trends in increased cancer-eliminated life expectancy. Results Between 1981 and 2015,there was a significant decrease in age-standardized PYLL among males (APC=-2.31%, 95% CI:-2.51% to-2.11%) and females (APC=-1.91%, 95% CI:-2.26% to-1.56%). However, an increase was found in cancer-eliminated life expectancy in males and females, from 3.23 to 4.72 years in males(APC=2.42%,95% CI:1.64% to 3.20%)and from 1.10 to 2.94 years in females(APC=3.91%, 95% CI: 1.78% to 6.04%). Conclusion An overall decrease in age-standardized PYLL was observed when all cancers were considered,and an increase in cancer-eliminated life expectancy was found, suggesting that premature deaths due to cancers were reduced gradually. However, the negative effects of cancer on the health of the whole population have not been fully alleviated.
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Objective To explore the mortality trends of cerebrovascular diseases and to quantitatively estimate the influence of population factors on cerebrovascular disease mortality between 1993 to 2016 in Kunshan city, Jiangsu province. Methods Records of cerebrovascular disease deaths were obtained from a register of all causes of death. Crude death rate and age standardized rate (ASR) were calculated, and annual percentage change (APC) based on sex and age were estimated. Difference decomposition was used to estimate the contribution of demographic and non?demographic factors to the change in cerebrovascular disease mortality. Results Between 1993 and 2013, the ASR of cerebrovascular diseases declined significantly for both sexes (APC=-4.9%, 95% CI:-5.5% to-4.3%), males alone (APC=-4.8%, 95% CI:-5.5% to-4.1%), and females alone (APC=-5.5%, 95% CI:-5.7% to-4.3%). However, from the year 2013 to 2016, the ASR of cerebrovascular diseases increased for both sexes together (APC=7.5%, 95% CI: 3.8% to 11.2%) and men alone (APC=10.2%, 95% CI: 4.3% to 16.1%), but there was no significant change for women (APC=4.3%, 95% CI:-1.2% to 9.8%). The overall decrease in mortality due to cerebrovascular disease was mainly due to non?demographic changes; the proportions of its contribution in men, women, and both sexes were 238.78%, 241.09%, and 245.89%, respectively. Conclusion The mortality due to cerebrovascular disease decreased substantially in the past two decades, and this decline was hindered by some demographic factors. It is imperative to explore the causes of this decline to decrease the burden caused by cerebrovascular disease.
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Objective To explore the temporal trend of cancer death rates in different age and the influencing factors in Kunshan,Jiangsu province,1981 to 2015.Methods Data were derived from cancer rcgistry and vital registration system.The Chinese age structure in 2000 was used to calculate age-standardized death rates (ASR),and annual percentage changes (APC) and 95% confidence interval (Cl) were used to estimate the temporal trend of cancer death rates.Difference decomposition method was applied to analyze the contribution of demographic and non-demographic factors for the change of cancer mortality.Results Between 1981 and 2015,the age standardized all cancers death rate decreased from 162.49 to 93.74 per 100,000 (APC=-l.6%,95% CI:-1.8%--1.5%).However,the ASR for those aged 70 years or above was stable over time (APC=0.2%,95% CI:-0.2%-0.5%),whereas aged 30-69 years was decreased from 240.01 in 1981 to 93.28 in 2015 (APC=-2.8%,95% CI:-3.0%--2.6%).In addition,the proportion of leading cancers were changed obviously.The proportion of lung cancer increased from 1981 to 2015,while gastric cancer,liver cancer,esophageal cancer and colorectal cancer decreased.Compared with the crude cancer mortality in 1993,the effect of the demographic and non-demographic factors to the increased death rate in 2015 were 308.93% and-208.93%,respectively.Conclusion The ASR death rate of all cancers was decreasing,and the rate in those aged 30 to 69 years decreased significantly,whereas stable in those aged 70 years or above.The effect of demographic characteristics on cancer mortality was significantly greater than that of non-demographic characteristics.
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Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.
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Objective To study the regional cerebral blood flow (rCBF) and correlated factors in patients with hepatolenticular degeneration (HLD).Methods The rCBF of lentiform nucleus,thalamus and other sites in 14 patients with HLD of cerebral type (cerebral type group) and 10 patients with HLD of non-cerebral type (non-cerebral type group) were determined by magnetic resonance-perfusion imaging technology,meanwhile 13 healthy volunteers were selected as control group,and calculated the relative regional cerebral blood flow (rrCBF) for avoiding perfusion time lag.The correlation between the clinical symptom scores,the content of urinary copper,duration and rrCBF in HLD patients were evaluated.Results The rrCBF of cerebral type group in the left and right frontal lobe,temporal lobe,lentiform nucleus,caudate nucleus,thalamus,midbrain,pons and the left hippocampus,cerebellar cortex,dentate nucleus were lower than those of control group (1.91 ±0.35 vs.2.44 ±0.64,1.80 ±0.30 vs.2.37 ±0.65,1.37 ±0.35 vs.2.14 ±0.91,1.58 ±0.52 vs.2.39 ±0.99,1.61 ±0.38 vs.2.59 ±0.74,1.52 ±0.64 vs.2.63 ±0.73,1.88 ±0.32 vs.2.61 ±0.67,1.70 ±0.40 vs.2.35 ±0.50,1.48 ±0.13 vs.2.01 ±0.59,1.46 ±0.38 vs.2.38 ±0.99,1.47 ±0.55 vs.2.02 ±0.72,1.27 ±0.48 vs.1.91 ±0.51,1.24 ±0.38 vs.1.47 ±0.29,1.25 ±0.39 vs.1.53 ±0.37,1.74 ±0.27 vs.2.40 ±0.89,1.79 ±0.50 vs.2.22 ±0.66,2.15 ±0.41 vs.2.64 ± 0.61),and there were significant differences (P < 0.05 or < 0.01).There were no significant differences in the rrCBF of the parietal and occipital lobe,etc between cerebral type group and control group (P > 0.05).The rrCBF of cerebral type group in the left and right lentiform nucleus were lower than those of non-cerebral type group (1.61 ± 0.38 vs.1.94 ± 0.58,1.52 ± 0.64 vs.1.99 ± 0.59),and there were significant differences (P < 0.05).The clinical symptom scores were positively correlated with the rrCBF of the left and right lentiform nucleus in 24 patients with HLD (r =-0.792 and-0.764,P < 0.01),the content of urinary copper and duration had no correlation with the rrCBF of the left and right lentiform nucleus(P > 0.05).Conclusions The rCBF of cerebral type and non-cerebral type HLD is significantly reduced,cerebral type patients have lower rCBF than non-cerebral type patients.The rCBF is correlated with the clinical symptom scores.
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Objective To examine the dose-response relationship between gestational weight gain rate and the neonate birth weight.Methods A total of 18 868 women with singleton gestations who delivered between January 2006 and December 2013 were included in this study.Maternal and neonate details of these women were drawn from the Perinatal Monitoring System database.Gestational weight gain rate was defined as the total weight gain during the last and first prenatal care visits divided by the interval weeks.Both Multiple logistic regression analysis and restricted cubic spline methods were performed.Confounding factors included maternal age,education,pre-pregnancy body mass index (BMI),state of residence,parity,gestational weeks of prenatal care entry,and sex of the neonate.Results The adjusted odds ratio for macrosomia was associated with gestational weight gain rate in lower pre-pregnancy BMI (OR=3.15,95%CI:1.40-7.07),normal (OR=3.64,95%CI:2.84-4.66) or overweight (OR=2.37,95%CI:1.71-3.27).The odds ratios of low birth weight appeared a decrease in those women with lower pre-pregnancy BMI (OR=0.28,95%CI:0.13-0.61) while the normal weight (OR=0.37,95%CI:0.22-0.64) group with gestational weight gain,the rate showed an increase.Association of gestational weight gain rate for macrosomia was found a S-curve in those term delivery women (non-linearity test P<0.000 1).However,L-curve was observed for low birth weight and gestational weight gain rate in term births (non-linearity test P<0.000 1).Conclusion A S-curve was seen between gestational weight gain rate and term delivered macrosomia while L-curve was observed among term delivered low birth weight neonates.
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Objective To examine the brain metabolic changes in WD patients receiving copper chelation by us?ing 1H-MRS. Method Thirty-nine patients with WD was randomly divided into four groups: non-brain type group (18 cases), brain type prior-treatment group and short-term treatment group (21 cases), long-term treatment group (20 cases) from short-term treatment group, and 20 healthy volunteers served as a control group. 1H-MRS and MRI were performed on patients on 1.5/MR/MRS system to detect these above-mentioned items before and after treatment. Result The mean of NAA/Cr was significantly lower in the left putamen and head of the caudate nucleus than in the left basal ganglion in the 39 patients with WD. The mean of NAA/Cr and Cho/Cr in the left putamen and basal ganglion was significantly lower in non-brain type group than in control group(P0.05). The mean of NAA/Cr and NAA/Cho in the left putamen and basal ganglion was much higher in long-term treatment group than in brain type group(P<0.01 or P<0.05). The mean of Cho/Cr in the left head of caudate nucleus were much higher after treatment compared with prior-treatment group(P<0.05). The mean of NAA/Cr in the left putamen, head of the left caudate nucleus and basal ganglion in all groups was negatively correlated with course of the disease. Conclusion There are significant differences in brain metabolism among different type of WD. The long-term but not short-term copper chelation significantly improves brain metabolism. NAA/Cr may be used as a non-invasive indicator to examine the efficacy of treatment.
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<p><b>OBJECTIVE</b>To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care, number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW).</p><p><b>METHODS</b>Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high, senior high, junior college) of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles, according to the distribution of the original variables on pregnant women with newborns of normal birth weight.</p><p><b>RESULTS</b>Whether the pregnant women were stratified by educational level, with the increasing number of prenatal care visits, LBW risk was shown a U-type tendency in different strata of educational levels, when comparing with the reference group, respectively. Compared to the baseline group, the OR and 95% CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64), 0.55 (0.32-0.95), 0.50 (0.32-0.80), 0.36(0.20-0.66) in all subjects who had received educational levels as junior middle school, senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk (χ² = 4.650 2, P = 0.031 1). However, no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk (χ² = 0.929 7, P = 0.334 9).</p><p><b>CONCLUSION</b>Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits, but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.</p>
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Adult , Female , Humans , Infant, Newborn , Pregnancy , Young Adult , Educational Status , Gestational Age , Infant, Low Birth Weight , Logistic Models , Prenatal Care , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To estimate the dose response relationship between cigarette smoking and hypertension in men based on restricted cubic spline method.</p><p><b>METHODS</b>Under the proportion to the population size, 38 520 subjects were randomly selected from May to August 2012 with cluster sampling method in urban and rural areas of Kunshan, China.Each participant received face-to-face interview with the standardized questionnaire, and physical examination.Restricted cubic spline was employed to estimate the dose response relation of cigarette smoking on the risk of hypertension.</p><p><b>RESULTS</b>The overall prevalence of cigarette smoking was 22.6% (8 691/38 520), prevalence of cigarette smoking in men was 46.1% (8 499/18 454). Multiple logistic regression analysis showed that current smoking (OR = 1.16, 95%CI:1.05-1.28) and previous cigarette smoking (OR = 1.32, 95%CI:1.07-1.63) were associated with hypertension after adjusted confounding factors (age, sex, body mass index, education, family income per month, urban or rural areas, physical activity and physical exercise) in men. After further adjusting drinking status, only previous cigarette smoking was associated with hypertension (OR = 1.28, 95%CI:1.04-1.58). The restricted cubic spline model indicated a linear dose-response relation between hypertension and cigarette smoking per day in men (non-linearity test P = 0.604 1).However, a non-linear dose response relation was found between duration of smoking (non-linearity test P < 0.000 1), smoking index (non-linearity test P = 0.009 9) and hypertension.</p><p><b>CONCLUSION</b>Long-term and heavy cigarette smoking is associated with hypertension in men.</p>
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Adult , Aged , Humans , Male , Middle Aged , Alcohol Drinking , Body Mass Index , China , Epidemiology , Hypertension , Epidemiology , Prevalence , Risk Factors , Smoking , Epidemiology , Surveys and QuestionnairesABSTRACT
Objective To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care,number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW). Methods Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high,senior high,junior college)of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles,according to the distribution of the original variables on pregnant women with newborns of normal birth weight. Results Whether the pregnant women were stratified by educational level,with the increasing number of prenatal care visits,LBW risk was shown a U-type tendency in different strata of educational levels,when comparing with the reference group,respectively. Compared to the baseline group,the OR and 95%CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64),0.55(0.32-0.95),0.50(0.32-0.80),0.36(0.20-0.66)in all subjects who had received educational levels as junior middle school,senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk(χ2=4.650 2,P=0.031 1). However,no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk(χ2=0.929 7,P=0.334 9). Conclusion Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits,but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.
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Objective To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care,number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW). Methods Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high,senior high,junior college)of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles,according to the distribution of the original variables on pregnant women with newborns of normal birth weight. Results Whether the pregnant women were stratified by educational level,with the increasing number of prenatal care visits,LBW risk was shown a U-type tendency in different strata of educational levels,when comparing with the reference group,respectively. Compared to the baseline group,the OR and 95%CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64),0.55(0.32-0.95),0.50(0.32-0.80),0.36(0.20-0.66)in all subjects who had received educational levels as junior middle school,senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk(χ2=4.650 2,P=0.031 1). However,no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk(χ2=0.929 7,P=0.334 9). Conclusion Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits,but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.
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Objective To observe whether recent sexual intercourse might cause microscopic hematuria, and investigate the cause of hematuria. Methods Eighty healthy volunteers (40 men and 40 women) consented to have intercourse with their married couples and provide samples of urine for testing before intercourse and the first day morning, noon, evening and the second day morning after intercourse. After appropriate instruction, volunteers tested their own urine for the presence of blood using standard dipsticks. Any volunteer with hematuria after intercourse was offered a comprehensive hematuria assessment and followed-up for two years. Results None of the volunteers had positive hematuria before sexual intercourse. 9 of the 40 women, but no men, had positive hematuria at the first day morning after intercourse, and 3 of the nine patients with hematuria still had positive hematuria at the noon of the first day. Five women of 9 patients with hematuria accepted two years follow-up and no abnormal was identified. Conclusion It suggested that recent sexual intercourse was a cause of asymptomatic microscopic hematuria in women, and a history of recent sexual intercourse should be considered when assessing the clinical significance of microscopic hematuria in women.